“I wanted to die and felt like it was the end of the world,” says Talbert, 58, who has both psoriasis and psoriatic arthritis. “I stopped going to salons for a few years. I couldn’t take the embarrassment or shame of having this disease.”
The National Psoriasis Foundation (NPF) estimates that at least half of people with psoriasis have it on their scalp. The symptoms can range from mild scales and flaking to thick, crusty plaques that cover the entire scalp. Most scalp psoriasis causes dandruff-type flaking that can be embarrassing and difficult to hide.
People with scalp psoriasis may feel embarrassed or even stigmatized, particularly when others mistakenly think the condition is contagious. A trip to the hair salon can be especially stressful.
But there are some steps you can take to manage scalp psoriasis and fight those stubborn flakes. Here are five simple tips.
1. Find a Stylist Who Understands Your Condition and Concerns
When scheduling an appointment with a stylist, be up-front about your psoriasis and any concerns you have.
“Whenever I got up the courage to visit a new hair stylist, my stomach twisted in knots as they combed through my hair,” says Talbert. “I would try to explain my condition and apologize because I had psoriasis. I could feel the anxiety building because I didn’t know what this person would say or think about me.”
If the stylist seems uncomfortable about doing your hair, go to someone else. Otherwise, you’re unlikely to get the attention or results that you want and deserve.
Some salons have more experience with clients who have skin and hair conditions. Andrew Kim is a Toronto-based trichologist, or specialist in hair loss and scalp issues, and he is the founder and owner of the Odjibik salon.
“Find local trichologists,” Kim says. “They will better understand your situation and have more experience and knowledge in taking care of clients with scalp disorders or hair loss.”
2. Try a Non-Topical Treatment
If you’re tired of dealing with messy, topical treatments for psoriasis flakes, ask your dermatologist about other treatment options, like light or laser therapy.
Phototherapy treats psoriasis by exposing skin to ultraviolet light, which slows the growth of skin cells. It can be done at your dermatologist’s office and sometimes can even be administered at home. Often light treatments are used in conjunction with medications.
Another option is laser treatment, in which a device known as an excimer laser is used to administer ultraviolet light directed at the skin. According to a study published in 2004 in the journal JAMA Dermatology, excimer laser therapy was effective in reducing plaques and redness in a woman who had scalp psoriasis for 20 years and had used many topical treatments. The study’s authors noted that the laser can be more targeted to treat specific areas of the skin affected by psoriasis.
3. Take New Hair Products for a Test Run First
For people with dry scalps, over-the-counter anti-dandruff shampoos can be effective. But for people who have scalp psoriasis, even a mild shampoo or conditioner can cause their condition to flare up.
“Even with shampooing, patches will not be easily removed,” Kim says. “Find a good scalp exfoliator that contains salicylic acid, and rub it on patches before shampooing. Leave it for five minutes and then shampoo. If you want to use natural exfoliators, try olive oil or coconut oil. Apply it on patches, rub, and leave it for 10 minutes. Then shampoo off.”
To test out a shampoo or other hair product, work it into the ends of your hair and gradually move up toward the scalp. Stop about an inch away from the skin.
There are shampoos specifically designed to treat the symptoms of scalp psoriasis. Most of these contain either coal tar or salicylic acid, which acts as an exfoliant and helps remove dead skin cells. But these shampoos can dry out the hair and skin. Try a combination shampoo-and-conditioner or a psoriasis-specific conditioner to help lock in moisture.
4. Don’t Pick at Plaques
It can be hard to avoid picking at uncomfortable and unsightly plaques or dead skin. But scratching and picking will only irritate your skin more and could trigger new flares elsewhere on your scalp and head.
Try one of these NPF-recommended remedies instead:
Over-the-counter ointments such as hydrocortisone cream or calamine lotion may help with mild itching. Test them first on a small area of skin.
A lotion or conditioner containing salicylic or lactic acid can help prevent plaques from cracking and flaking.
For scalp psoriasis that isn’t covered by hair, apply a lotion or moisturizer that will soften the skin.
5. Accessorize Strategically
If you have scalp psoriasis, some flaking is probably inevitable. Dressing strategically so psoriasis flakes aren’t as apparent may ease any anxiety you’re feeling.
Wear light colors, instead of black or navy, so flakes will be less noticeable. A light-colored scarf around your neck can also help catch or camouflage any flakes.